• Journal of rehabilitation welfare engineering & assistive technology
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• v.7 no.1
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• pp.13-19
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• 2013

The aim of this study was to investigate difference of the muscle activation patterns of the upper body during wheelchair cycle ramps ascent of different slopes for disabled with spinal cord injury. Three subjects who is disabled with spinal cord injury participated in this study. Surface electromyography (EMG) data (reaction time [RT], onset-offset time, and peak value of muscle activation) were collected biceps, triceps, upper trapezius, anterior deltoid, latissimus dorsi, and upper rectus abdominal muscles during wheelchair cycle ramps ascent ($0^{\circ}$, $3^{\circ}$, and $6^{\circ}$). For latissimus dorsi muscle, RT and peak value of muscle activation was were increased and offset time was delayed as the slope increased (p < 0.05). These results indicate that wheelchair cycle ramps ascent might cause excessive overuse of latissimus dorsi muscle.

• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.261-266
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• 2009

Rhabdomyolysis, the clinical syndrome caused by the injury to skeletal muscle resulting in the release of muscle cell contents into the systemic circulation, has been described in association with various factors. The causes include crush injury, skeletal muscle overuse, heat, drug, abuse of alcohols and metabolic disorders as well as several types of viral and bacterial infections. We report two cases of rhabdomyolysis, which were complicated by uncommon causes, parainfluenza virus type I infection and hypernatremia.

• Clinical Pain
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• v.18 no.2
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• pp.107-110
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• 2019

Flexor carpi radialis (FCR) muscle is located in the forearm anteriorly that runs through a synovial fibro-osseous tunnel in the forearm. We described a case of FCR tendon rupture due to repetitive overuse injury. A 55-year-old man, right-hand dominant, presented with right forearm pain and swelling which started 3 days ago while playing amateur golf. Focal tenderness and bruising over volo-ulnar region of the right forearm were examined. Plain radiographs showed soft tissue edema around lesion area and no detectable fracture. Ultrasonography showed multiple hypoechoic lesions suspected as hematoma of the flexor muscle group. After done magnetic resonance imaging, he was diagnosed with rupture of FCR tendon at proximal origin and strain of flexor digitorum superficialis and palmaris longus muscle. He received compressive dressing and restriction of wrist range of motion for three weeks. Two months later, remaining traces of lesions were observed at the follow-up ultrasonography and the pain disappeared.

• Journal of Korean Physical Therapy Science
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• v.1 no.2
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• pp.313-320
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• 1994

This article provids background information necessary to design orthopaedic physical therapy programs based on a patient's level of orthopaedic involvement during the acute, subacute, or chronic stage of soft-tissue healing. This approach was used whether the problem involved injury from trauma, insult from overuse, disease, surgical intervention. Soft-tissue lesions and clinical conditions were defined ; the stages of inflammation and repair were described with emphasis on how to manage soft tissues and joints with therapeutic exercise during each stage. A problem list with goals and plan of care was outlined to summarize each clinical situation. A list of clinical problems will be used as the foundation for designing exercise problems for each region of the body.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.16-21
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• 2010

The prevalence of overuse syndrome in the lower extremity including chronic compartment syndrome and stress fracture is increasing with popularity of sports activities. Chronic compartment syndrome is defined as elevation of the interstitial pressure during exertional activities in a closed osseofascial compartment that results in microvascular compromise and operative procedures can be necessary if conservative treatments fail. Stress fracture can be classified as fatigue and insufficiency fracture; stress fracture occurs by repeated strain under abnormal conditions from the patient's activity whereas insufficiency fracture does by those from a process intrinsic to the bone. Most stress fractures occur in the lower extremity, most commonly in the tibial region. Fatigue fractures begin in athletes with the change in their training programs. The radiographic findings are usually diagnostic or at least strongly suggestive and MRI has proven to be a beneficial diagnostic tool for difficult diagnostic cases. Fatigue fractures are treated with a decrease in activity, but surgical procedure may be necessary in those in anterior cortex of the tibial diaphysis.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.44-49
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• 2003

Purpose: To estimate the prevalence and incidence of patellar tendinitis, to discover the patellar tendinitis in top level male volley ball players. Materials and Methods: Thirteen members of the male adult volleyball players were included in this study. From history and physical examination, 3 of the 13 players had patellar tendon pain associated with activity and were diagnosed as patellar tendinitis at the time of the study. Investigators were blinded about the injury status of the players. For all players, data such as age, volleyball experience, amount of training and competition hours were recorded. Results: Of the thirteen cases, two spikers complained pain on the lower pole of the patella, one setter on the upper pole. Conclusion: This findings suggest that patellar tendinitis in the volleyball players are influenced by the amount of the practice and their position. In most cases, the supervised control of the practice will reduce the overuse injuries in the volleyball players.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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• pp.21-32
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• 2022

Background: Instrument players are exposed to occupational musculoskeletal symptoms due to constant movement and strain to meet the needs of their audience. This can cause dissonance between the player and the instrument and can cause medical problems in the musculoskeletal system such as pain, tendinitis, muscle spasms, and joint hyperextension from overuse of body parts. Objective: The purpose of this study is to comparatively analyze the characteristics and occurrence of musculoskeletal symptoms in professional and student players, and to find out the awareness of the need for health care professionals and special exercise programs for orchestra players. Methods: The subjects were professional orchestral musicians 191 from the three symphony orchestras and music students 209 from the four universities volunteered to participate in this study; 393 subjects (98.25%) completed the questionnaire. symptom prevalence and related factors of playing-related musculoskeletal disorders (PRMDs) were surveyed with a self-administered questionnaire. Standardized Nordic Questionnaire was complemented by adding a visual-among scale and used to diagnose PRMD. Results: High prevalence of musculoskeletal complaints in both professional musicians (85.30%) and student musicians (82.30%). Professional musicians and student musicians also suffered the highest problem in shoulder and neck complaints. Significant differences were found between groups that recognized of necessity for specialized health professionals, professional organizations, and special programs for musicians. Conclusions: Professional musicians and student musicians, like orchestra players, are already exposed to overuse syndrome. However, student musicians lack awareness of the risk of injury compared to orchestra players. We suggest that an appropriate treatment management program for the prevention and early treatment of musculoskeletal system damage should be provided to performers at an early stage.

• Journal of Life Science
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• v.20 no.2
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• pp.314-320
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• 2010

As the nature of triathlons is competition in three successive sports, triathletes experience elevated levels of stress on the body that are absent in single-sport athletic events, and consequently there are more potential medical problems to prepare for. Triathletes can also experience problems such as hypothermia, heat illness, excessive exposure to ultraviolet radiation, musculoskeletal injuries and trauma, immunosuppression, and haemolysis. Depending on the potentiality of such above-listed problems occurring in any given race, race organizers will prepare preventative measures and treatments accordingly. Olympic distance is not the only triathlon racing distance. Sprints, which are normally around half the Olympic distance, are common distances, as well as Long (2 km swim, 80 km bike, 20 km run), Ironman (3.8 km swim, 180 km bike, 42 km run), and ultra-distance events varying in length. Races of longer duration normally result in a higher percentage of athletes experiencing the above-mentioned medical problems, as well as inducing additional health risks such as hyponatraemia. Minimizing the occurrences of serious health issues is possible through the following means: carefully preparing for the probable race-day weather conditions; proper management and organization of the race; preparing an extensive water-safety and ground-course safety plan; distributing necessary nutrition along the course; and stressing the importance for athletes to have proper knowledge concerning race nutrition, biomechanical technique, physical preparation, and utilization of safe equipment. While risks of competing in triathlon are many, the instances of such medical problems are not excessive, and the triathlon has a reputation of being a reasonably safe sport as long as athletes with high risk take added precautions.

• Physical Therapy Korea
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• v.11 no.4
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• pp.7-17
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• 2004

Individuals who propel wheelchairs have a high prevalence of upper extremity injuries (i.e., carpal tunnel syndrome, elbow/shoulder tendonitis, impingement syndrome). Musculoskeletal injuries can result from overuse or incorrect use of manual wheelchairs, and can hinder rehabilitation efforts. To better understand the mechanisms of upper extremity injuries, this study investigates the motion of the wrist during wheelchair propulsion. This study also examines changes in the variables that occur with fatiguing wheelchair propulsion to determine how the time parameters of wheelchair propulsion and the state of fatigue influence the risk of injury. A two dimensional (2-D) analysis of wrist movement during the wheelchair stroke was performed. Twenty subjects propelled a wheelchair handrim on a motor-driven treadmill at two different velocities (50, 70 m/min). The results of this study were as follows; The difference in time parameters of wheelchair propulsion (cadence, cycle time, push time, recovery time, and PSP ratio) at two different velocities was statistically significant. The wrist kinematic characteristics had statistically significant differences at two different velocities, but wrist radial deviation and elbow flexion/extension had no statistically significant differences. There were statistically significant differences in relation to fatigue in the time parameter of wheelchair propulsion (70 m/min) between initial 1 minute and final 1 minute. The wrist kinematic characteristics between the initial 1 minute and final 1 minute in relation to fatigue had statistically significant differences but the wrist flexion-extension (50 m/min) had no statistically significant differences. According to the results, the risk of musculoskeletal injuries is increased by fatigue from wheelchair propulsion. To prevent musculoskeletal injuries, wheelchair users should train in a muscle endurance program and consider wearing a splinting/grove. Moreover, wheelchair users need education on propulsion posture, suitable joint position, and proper recovery patterns of propulsion.